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New AMA policy recognizes racism as a public health threat


 

New policy adopted by physicians at the American Medical Association's (AMA) Special Meeting of its House of Delegates (HOD) recognizes racism as a public health threat and commits to actively work on dismantling racist policies and practices across all of health care.

In June 2020, the AMA Board of Trustees acknowledged the health consequences of violent police interactions and denounced racism as an urgent threat to public health, pledging action to confront systemic racism, racial injustice and police brutality.

The new policy approved by the AMA, representing physicians and medical students from every state and medical specialty, opposes all forms of racism as a threat to public health and calls on AMA to take prescribed steps to combat racism, including: (1) acknowledging the harm caused by racism and unconscious bias within medical research and health care; (2) identifying tactics to counter racism and mitigate its health effects; (3) encouraging medical education curricula to promote a greater understanding of the topic; (4) supporting external policy development and funding for researching racism's health risks and damages; and (5) working to prevent influences of racism and bias in health technology innovation.

"The AMA recognizes that racism negatively impacts and exacerbates health inequities among historically marginalized communities. Without systemic and structural-level change, health inequities will continue to exist, and the overall health of the nation will suffer," said AMA Board Member Willarda V. Edwards, M.D., M.B.A. "As physicians and leaders in medicine, we are committed to optimal health for all, and are working to ensure all people and communities reach their full health potential. Declaring racism as an urgent public health threat is a step in the right direction toward advancing equity in medicine and public health, while creating pathways for truth, healing, and reconciliation."

Though previous AMA policies and principles have emphasized the need to eliminate health disparities and called on physicians to prevent violence of all kinds, the new policy explicitly acknowledges racism's role in perpetuating health inequities and inciting harm against historically marginalized communities and society as a whole.

Specifically, the new policy recognizes racism in its systemic, cultural, interpersonal, and other forms as a serious threat to public health, to the advancement of health equity, and a barrier to appropriate medical care. It makes clear that a proactive approach to prevent, or identify and eliminate, racism is crucial - particularly considering that studies show historically marginalized populations in the U.S. have shorter lifespans, greater physical and mental illness burden, earlier onset and aggressive progression of disease, higher maternal and infant mortality, and less access to health care.

The policy describes the various forms of racism as follows:

  • Systemic racism: structural and legalized system that results in differential access to goods and services, including health care services.
  • Cultural racism: negative and harmful racial stereotypes portrayed in culturally shared media and experiences.
  • Interpersonal racism: implicit and explicit racial prejudice, including explicitly expressed racist beliefs and implicitly held racist attitudes and actions based upon or resulting from these prejudices.

In addition, the new policy requests AMA to identify a set of best practices for health care institutions, physician practices, and academic medical centers to address and mitigate the effects of racism on patients, providers, international medical graduates, and populations. It also guides the AMA's position on developing and implementing medical education programs that generate a deeper understanding of the causes, influences and effects of all forms of racism -- and how to prevent and improve the health effects of racism.

Further, the policy asks that AMA support the creation of external policy to combat racism and its effects and encourage federal agencies and other organizations to expand research funding into the epidemiology of risks and damages related to racism. Additionally, the policy asserts that the AMA will work to prevent, and protect against the influences of racism and bias in innovative health technologies.

The AMA has been leading an aggressive effort to embed equity in thoughts, actions, and processes so as not to perpetuate inequities and instead help people live healthier lives. In 2018, the AMA adopted policy to define health equity and outline a strategic framework toward achieving optimal health for all. To help navigate these challenges, in 2019 the AMA hired its first chief health equity officer to establish the AMA's Center for Health Equity to elevate and sustain efforts to address systemic level changes that can improve health.

Fully understanding that there is tremendous work still to be done to ensure that everyone has the opportunity, conditions, resources, and power to achieve optimal health, the AMA is committed to collaborating with stakeholders to confront the issue of racism within our society. The AMA continues to urge other leading health organizations to also take up the mantle of intolerance for racism as it pushes upstream to dismantle racism across all of health care -- driving the future of medicine toward anti-racism.

 
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